O Schmitt

University of Bonn, Bonn, North Rhine-Westphalia, Germany

Are you O Schmitt?

Claim your profile

Publications (100)123.43 Total impact

  • L. Perlick, V. Rolf, T. Wallny, O. Schmitt
    [Show abstract] [Hide abstract]
    ABSTRACT: Bei der fibrösen Dysplasie finden sich in seltenen Fällen, sowohl bei der mono- als auch polyostotischen Form, eine Beteiligung der Halswirbelsäule (HWS). In der Mehrzahl handelt es sich um Zufallsbefunde im Rahmen der radiologischen Diagnostik. Es wird ein symptomatischer Fall mit atlantoaxialer Instabilität bei Befall des 1., 2. und 3. Halswirbelkörpers vorgestellt. Im Fall einer 53 jährigen Patientin, bei der seit 3 Monaten eine zervikale Myelopathie vorlag, wurde anhand von Nativröntgenaufnahmen und CT-Untersuchung eine zervikale fibröse Dysplasie diagnostiziert. Als Ursache der Symptomatik lag eine atlantoaxiale Instabilität vor. Es erfolgte eine dorsale Stabilisierung mit dem DCS-System. Fibrous dysplasia, in either monostotic or poliostotic form rarely involves the cervical spine. Most of these lesions remain asymtomatic and are incidental radiographic findings. A symptomatic case of polyostotic fibrous dysplasia involving the first, second and third cervical vertebra with potentially serious consequences is presented. A 53-year old woman who had shown cervical myelopathy for about 3 month was diagnosed as having cervical dysplasia on the basis of plain x-ray and CT scanning. In addition, atlanto-axial instability causing clinical symptoms was detected. A dorsal stabilisation was perfomed using the DCS System.
    Der Unfallchirurg 04/2012; 103(1):73-75. · 0.64 Impact Factor
  • Zeitschrift für Orthopädie 09/2006; 144(5):459-463. · 0.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Severity of vertical impact to the coccyx can range from mere contusion to a dislocated fracture of the coccyx. With early conservative management, most patients have a good prognosis and heal within weeks to months after the initial trauma. Occasionally, persisting symptoms make a surgical intervention with coccygectomy necessary. We report on the results of patients surgically managed for traumatically induced, persisting coccygodynia and compare these to patients operatively treated for idiopathic coccygodynia. Sixteen patients with an average follow-up of 7.3 years were evaluated. Of these, eight were surgically treated for traumatic and eight for idiopathic coccygodynia. The clinical results were assessed by means of the Hambly Score and the Oswestry Low Back Pain Disability questionnaire. Patient satisfaction with the postoperative result was assessed by a visual analog scale. Seven of eight (88%) patients treated for traumatically induced coccygodynia had a good or excellent postoperative result, in contrast to only three of eight (38%) patients with idiopathic coccygodynia. The former group had better results in terms of sitting tolerance and general pain intensity as represented by the Oswestry Low Back Pain Disability questionnaire. According to the significantly better clinical results, personal satisfaction was clearly higher in the traumatic group. These results suggest that, in patients where all conservative treatment methods work to no avail, particularly those with traumatically induced persisting coccygodynia benefit from surgical intervention with coccygectomy.
    The Journal of trauma 01/2006; 59(6):1414-9. · 2.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: By means of conventional internet search engines we assessed the World Wide Web for the topic "epicondylitis radialis humeri" and analysed the content of the listed pages for their quality and transparency. Three of the most frequently used internet search engines were utilised to search the World Wide Web for the terms "tennis arm", "tennis elbow" and "epicondylitis". The first 50 listed internet addresses per search engine were scrutinised in respect to the authors' source, financier of the web page and whether commercial interests were evident. Furthermore, the medical content concerning radial epicondylitis was analysed using a 10-point score. After elimination of repetitive and not accessible internet pages, as well as web pages only giving links to further web-sites or chat-rooms, we were able to evaluate 137 internet sites. The average content-score of all pages was low with 2.91 +/- 3.27 SD. Web-pages, where authorship could not be identified or where commercial interests were clearly evident, had the lowest content-scores. Sites authored by or associated with orthopaedic surgeons had a significantly higher content-score (6.84 +/- 3.17 SD) in comparison to other initiators of web-pages (p < 0.0001). The facts derived from the World Wide Web when searching for information on epicondylitis radialis humeri are mostly of low professional quality and transparency. Orthopaedic surgeons need to point out this problem to patients who additionally inform themselves on the internet. If the desire for browsing the web for further information concerning musculoskeletal pathology exists, orthopaedic surgeons should tell their patients which web sites are suitable.
    Zeitschrift für Orthopädie 01/2006; 144(2):218-22. · 0.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We assessed to what degree orthopaedic patients use the internet as an information platform and how these patients rate the information they obtain over the World Wide Web (WWW). 450 consecutive patients consulting the out-patient department of our university clinic for the first time anonymously filled out a three-page questionnaire. Apart from clinical and sociodemographic data, the questionnaire addressed aspects such as the availability of computers and internet. Also, questions concerning the use and interpretation of medical information freely available on the WWW were asked. 402 questionnaires were evaluated. 54 % of the patients stated that they readily had access to the internet. Of the remaining patients without internet access, 19 % planned the installation in the near future. The prevalence of the use of the WWW of patients in the age group up to 40 years was 72 % and in patients over 40 years only 49 %. Compared with internet non-users, internet users were younger (p < 0.001), more frequently men (p < 0.05), and of a higher education level (p < 0.001). 68 % used the internet on a regular basis with regard to queries concerning their health and well being. More than every third patient (38 %) had consulted the internet about the specific orthopaedic ailment prior to seeking advice in our clinic. Almost half of the patients judged the previous treatment to be partially in accordance with the information obtained from the internet. 86 % considered the information obtained over the WWW as helpful or very helpful. 85 % would recommend other patients to use the internet for information concerning their orthopaedic complaint. 65 % of all patients objected to an orthopaedic on-line consultation via internet. The internet seems to be an important source of information for orthopaedic patients. The prevalence concerning the use of the WWW is particularly high in younger, well educated patients.
    Zeitschrift für Orthopädie 01/2006; 144(5):459-63. · 0.86 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We studied the brace effect on the spinal profile in idiopathic scoliosis, using a MR procedure visualising the complete scoliotic spine in any vertical plane, while rotating it 180 degrees on the longitudinal axis of the patient. Thirty-eight female patients (mean age, 14.5 years) were included in the study. Inclusion criteria were an idiopathic scoliosis, a Cobb angle greater than 20 degrees , age of 10-17 years and bracing with a Cheneau brace. The brace effect was studied in 38 thoracic curves. The MR examinations were carried out in direct sequences, with and without brace. A reconstruction algorithm allows visualising the whole spine in vertical projections, with rotational steps of 2 degrees , from -90 degrees to 90 degrees , referred to as MR animation. In various vertical MR projections, the changes of the curves were evaluated by measuring the Cobb angle. Additionally, a translation angle of the apical vertebra was determined, representing the lateral deviation of the apical vertebra from a defined midline. Testing the reproducibility of the Cobb angles, the standard deviation of the intra-individual differences was 1.7 degrees and of the inter-individual differences, 2.1 degrees . For the translation angles, the standard deviation of the intra-individual differences was 0.8 degrees and of the inter-individual differences, 0.9 degrees . With brace the mean Cobb angle of the thoracic curves was significantly reduced in the various vertical MR projections. The mean translation angle was also reduced. MR analysis showed that the brace effect is a translation process, straightening the profile of the scoliotic spine in all vertical planes. MR animation allows visualising the brace effect on the spine in scoliosis based on a 3D data set, without additional radiation exposure. It showed the straightening effect of the brace leading to a flattening of the sagittal spinal profile.
    European Spine Journal 04/2005; 14(2):138-43. · 2.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 65-year-old patient was referred to our clinic with persisting, severe tinnitus aurium. Due to the facts that prior otolaryngological as well as neurological assessment had been unremarkable and that the patient showed marked degenerative changes in the cervical spine the referring orthopaedic surgeon suggested the cause to be of vertebral origin. Case history showed that the tinnitus had spontaneously occurred and was pulse synchronous. Overall clinical evaluation of the cervical spine was inconspicuous. A brachialgia or other symptoms typically associated with a degenerative cervical syndrome could not be provoked. On the basis of this atypical clinical picture we performed a digital subtraction angiography (DSA) to exclude pathology in the vicinity of the cerebral vessels. This revealed an arteriovenous fistula of the sigmoid sinus which was then, under the auspices of our neurosurgeons, successfully closed by Gugliemo coil embolism. The patient reported that the tinnitus subsided almost immediately. This case demonstrates that despite the manifold pathology that is associated with degenerative cervical syndrome, pulse synchronous tinnitus aurium needs further clarification. Had the case history been taken more accurately and the quality of the tinnitus assessed earlier, the period between onset of symptoms and correct treatment could have been decreased significantly.
    Zeitschrift für Orthopädie 01/2005; 143(5):594-7. · 0.86 Impact Factor
  • Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete - Z ORTHOP GRENZGEB. 01/2005; 143(5):594-597.
  • [Show abstract] [Hide abstract]
    ABSTRACT: How well do ultrasound- and MRI-results after rotator cuff reconstruction correlate with postoperative clinical findings? Ultrasound- and MR-imaging of the afflicted shoulder on 40 patients who were surgically managed for isolated tear of the tendon of supraspinatus was performed at least 24 months after intervention. Patients were also clinically assessed. Based on the clinical result, sensitivity and specificity for the two imaging procedures was determined. Only 11 (27.5%) patients had a completely inconspicuous ultrasonography. By ignoring the sonographic parameter "echogenicity" this number was raised to 29 (72.5%) patients. Without the above mentioned parameter ultrasonography demonstrated a good specificity (90.3%) yet a poor sensitivity (33.3%). Incorporation of "echogenicity" markedly weakened both values. MR-imaging showed an intact cuff in 32 (80%) patients, 5 (12.5%) had signs for a partial tear and in 3 (7.5%) a recurrent tear was diagnosed. Based on the clinical result, MR-imaging showed sufficient specificity (87.1%), yet also a poor sensitivity (44.4%). After rotator cuff repair MRI- and ultrasound-findings frequently stand in distinct discrepancy to clinical results. Based on clinical findings, postoperative MR-imaging shows a slightly higher sensitivity than ultrasonography. Despite this, both radiographic methods do not allow deductions concerning the clinical outcome. The postoperative shoulder-scan and MRI should therefore be interpreted with utmost care. Symptoms and functional results are of high clinical relevance in the assessment of the postoperative shoulder.
    Ultraschall in der Medizin 03/2004; 25(1):40-7. · 4.65 Impact Factor
  • Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete - Z ORTHOP GRENZGEB. 01/2004; 142(5):598-602.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The value of MRI for pre-operative evaluation of the rotator cuff is proven. In spite of its clinical relevance, there have been only few studies on MR imaging of patients who have already been operated. Thus, the question rises to what extent the post-operative MRI can contribute to the evaluation of the integrity of the rotator cuff. At least 10 months after successful open repair of the supraspinatus tendon, mostly combined with Neer's anterior acromioplasty, an MR scan was performed on 33 shoulders. Only patients satisfied with the outcome of surgery and showing a Constant score of 65 to 100 points were included. More than half the patients had positive direct diagnostic criteria for a full- or partial-thickness tear of the supraspinatus tendon, in the form of signal intensity or morphological alterations. In addition, the indirect diagnostic criteria described by Zlatkin, such as the absence of the subacromial-subdeltoid fat or the appearance of subacromial-subdeltoid fluid, were often positive. Atrophy of the supraspinatus muscle, as a further indirect diagnostic criterion of a rupture, was also frequently noted. Taking the excellent clinical outcome of our patients into consideration, this study shows that caution should be taken in evaluating postoperative MR images. There is a high risk of over-interpreting MR findings.
    Zeitschrift für Orthopädie 01/2004; 142(5):586-91. · 0.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to assess the influence of interscalene brachial plexus blocks on the functional outcome, subjective pain appraisal and patient satisfaction after open shoulder surgery. These results were compared with patients treated by conventional analgesic measures. 23 patients with interscalene brachial plexus block (ISB) and 21 patients without ISB were evaluated preoperatively as well as 1, 7, 12 and 90 days after open surgery of the shoulder. By means of a visual analogue scale (VAS) subjective postoperative pain intensity was assessed. Using the Constant score preoperatively and 6 months after surgery the functional status of the treated shoulder was evaluated. At discharge from hospital patients were asked whether they were satisfied with the analgesic measures taken. The range of motion of the shoulder of patients treated with an ISB was significantly higher 1 and 7 days after surgery than those without ISB. 12 and 90 days postoperatively the range of motion in the ISB group was still higher, but no longer statistically significant. Assessment of the postoperative subjective pain status showed that patients with an ISB had significantly lower values and required less additional analgesia. In both groups the Constant score was significantly higher 6 months after surgery, compared to the preoperative condition. Compared to the control group, patients treated with ISB were clearly more satisfied with the postoperative pain management. By implementing ISB sufficient analgesia in the early postoperative period after open shoulder surgery is attained, allowing for early physiotherapy. This positively influences convalescence and the outcome of the surgical procedure. Furthermore, patients are visibly more satisfied with the postoperative pain management.
    Zeitschrift für Orthopädie 01/2004; 142(5):598-602. · 0.86 Impact Factor
  • U.A. WAGNER, O. SCHMITT, D. ICHIKAWA
    [Show abstract] [Hide abstract]
    ABSTRACT: Transfer of the posterior tibial tendon is frequently used for treatment of muscle imbalance, caused by neuromuscular diseases or irreparable damage of the common peroneal nerve. The present study evaluates different methods of posterior tibial tendon transfer both biomechanically in respect of the ankle dorsiflexion torque generated and clinical application. Torque measurements for eight cadaver specimens were averaged and plotted as a function of tendon tension. For the average range of motion from 35 degrees plantarflexion up to the neutral position, which reflects an applied force 10 to 30 N on the proximal end of the tendon, positioning sutured to the extensor retinaculum showed a significantly higher torque/force ratio (P<0.05) than the insertion beneath the retinaculum. There were no significant differences for the distal anchoring at the base of the metatarsal III or the os cuneiforme III. Results in 21 patients with positioning of the posterior tibial tendon above the retinaculum showed an improvement of gait in 16 of 18 patients, with excellent, good and satisfactory short-term results in 15 of 18 patients.
    Foot and Ankle Surgery 10/2003; 2(1):13 - 18.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Wear products of metal implants are known to induce biological events which may have profound consequences for the microcirculation of skeletal muscle. Using the skinfold chamber model and intravital microscopy we assessed microcirculatory parameters in skeletal muscle after confrontation with titanium and stainless-steel wear debris, comparing the results with those of bulk materials. Implantation of stainless-steel bulk and debris led to a distinct activation of leukocytes combined with a disruption of the microvascular endothelial integrity and massive leukocyte extravasation. While animals with bulk stainless steel showed a tendency to recuperation, stainless-steel wear debris induced such severe inflammation and massive oedema that the microcirculation broke down within 24 hours after implantation. Titanium bulk caused only a transient increase in leukocyte-endothelial cell interaction within the first 120 minutes and no significant change in macromolecular leakage, leukocyte extravasation or venular diameter. Titanium wear debris produced a markedly lower inflammatory reaction than stainless-steel bulk, indicating that a general benefit of bulk versus debris could not be claimed. Depending on its constituents, wear debris is capable of eliciting acute inflammation which may result in endothelial damage and subsequent failure of microperfusion. Our results indicate that not only the bulk properties of orthopaedic implants but also the microcirculatory implications of inevitable wear debris play a pivotal role in determining the biocompatibility of an implant.
    Journal of Bone and Joint Surgery - British Volume 02/2003; 85(1):133-41. · 2.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The radiological and clinical outcome of surgical treated thoracolumbal fractures were followed up after 6.7 years. The study encompassed 97 patients. The degrees of the bony deformation and the local kyphosis were measured on the lateral view X-ray at 4 different time points: post trauma, after the operation, before implant removal and at the follow up examination. The clinical outcome was evaluated by the Oswestry score. 74 fractures were treated with a fixateur intern and a dorsal fusion by apposition of autologous bone postero-laterally. 23 fractures were fused in a combined dorso-ventral manner by intervertebral fusion with tricortical autologous bone. The lateral X-rays showed a loss of correction up to 48 % in the dorsal fused group and 10 % loss of correction in the combined group. The local kyphosis increased up to 84 % in the dorsal operated group due to degeneration of the injured disk. The clinical Oswestry score showed no significant difference in both groups. The additional ventral surgery should be evaluated carefully.
    Zeitschrift für Orthopädie 01/2003; 141(5):573-7. · 0.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Severe progressive curve deformities in children's congenital scoliosis often require an early operative intervention. As spinal fusion interferes with longitudinal growth, a "growth enabling" operative device may represent an alternative method to delay a progressive curve deformity until an eventual operative intervention can be carried out. We report on the five-year follow-up of a seven-year-old girl who presented at our clinic with severe congenital scoliosis of 62 degrees with a unilateral unsegmented bar between T7 and T12 and an anomaly of segmentation between L2 and L4. An intermittent distracting rod was implanted with transpedicular fixation from T3/T5 to L3/L4. The correction was obtained by distraction of the mobile segments and also by hemiepiphyseodesis between L2 and L4. The rod's longitudinal extension could be distracted using a special thread. Three successive operations to obtain a minimal access to the thread were necessary to achieve a correction to an angle of 30 degrees with a total rod distraction of 4.5 cm.
    European Journal of Pediatric Surgery 01/2003; 12(6):416-8. · 0.84 Impact Factor
  • Journal of Bone and Joint Surgery-british Volume - J BONE JOINT SURG-BRIT VOL. 01/2003; 85(1):133-141.
  • Zeitschrift für Orthopädie 11/2002; 140(6):632-636. · 0.86 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Of 42 patients with resolving infantile idiopathic scoliosis, 34 were followed up for more than 25 years. Twenty had been primarily treated in a plaster bed and 14 by physiotherapy. The mean angle of the curve at presentation was 17 degrees and at follow-up it was 5 degrees. No patient had significant progression of the scoliosis during the growth spurt. When adults few had back pain or an increased disability score and there was no interference with work or social activities. The rib-vertebra angle difference proved to be an essential radiological sign when distinguishing resolving from progressive infantile idiopathic scoliosis. There was no advantage of plaster over physiotherapy with regard to either the time to resolution or the functional outcome. Treatment of resolving infantile idiopathic scoliosis in a plaster bed is therefore now outdated.
    Journal of Bone and Joint Surgery - British Volume 10/2002; 84(7):1030-5. · 2.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to evaluate FDG-PET findings in patients with osteoporosis or preclinical osteoporosis and acute vertebral compression fractures in order to determine whether FDG-PET has a value for distinction of pathological from osteoporotic vertebral fractures. 17 patients with a spontaneous compression fracture of the spine were evaluated by bone scanning with Tc-99m HDP, positron emission tomography with fluorine-18 deoxyglucose (FDG-PET) and magnetic resonance imaging (MRI). Osteoporosis had been established in all cases by X-ray and osteodensitometry. PET and bone scan images were scored independently from 0 (no pathological uptake) to 4 (definitive pathological uptake) by two blinded nuclear medicine physicians. The results of the blinded scoring were compared to MRI findings which served as gold standard. In 13 out of 17 patients, MRI demonstrated a vertebral fracture generating from osteoporosis. In 12 of these 13 cases, PET scans were scored with 0 or 1 and categorized as true negative. Standard uptake values (SUV) ranged between 1.1 and 2.4. In one of the 13 patients, PET was interpreted false positive with an uptake score of 3 (SUV = 2.9). Of the 17 patients, MRI revealed a pathological fracture caused by spondylodiscitis in three patients and by plasmacytoma in one patient. In these patients, all PET scans were highly positive with a score of 3 and 4 and SUV values between 3.8 to 9.8. The bone scans of all 17 patients were positive with scores of 3 or 4 but a differentiation between osteoporotic and pathological fractures was not possible. Our preliminary results indicate that acute vertebral fractures that originated from osteoporosis or preclinical osteoporosis tend to have no pathologically increased FDG uptake. Since a high FDG uptake is characteristic for malignant and inflammatory processes, use of FDG-PET may have potential value for differentiation between osteoporotic and pathological vertebral fractures.
    Osteoporosis International 10/2002; 13(9):755-61. · 4.04 Impact Factor

Publication Stats

508 Citations
123.43 Total Impact Points

Institutions

  • 1995–2012
    • University of Bonn
      • Poliklinik für Kieferorthopädie
      Bonn, North Rhine-Westphalia, Germany
  • 2003
    • St. Joseph Krankenhaus
      Berlín, Berlin, Germany
  • 1994–2001
    • University of Bonn - Medical Center
      Bonn, North Rhine-Westphalia, Germany